http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms855b.pdfCMS-855B – Medicare Enrollment Application – Centers for …
the CMS 855B) as an initial application when reporting a change for the first …. change to your enrollment information will require you to submit a CMS-588 form.

http://www.masspro.org/IMMS/docs/educationtraining/MassImmunizationRosterBilling6-15-10.pdfMass Immunization Roster Billing and CMS-855B … – Masspro
Jun 15, 2010 … imply any form of endorsement. … the CMS-855B and/or the CMS-855I to enroll or make a change in … Page 5 of the CMS-855B (Cont.).

http://www.aaahc.org/Global/pdfs/MDS%20content/Initial%20Medicare%20Certification%20Process%20MDSHB2012.pdfInitial Medicare Certification Process – The Accreditation Association …
Use this link: https://nppes.cms.hhs.gov or call 1-800-465-3203 for instructions and forms for obtaining NPI numbers. The ASC must complete the CMS 855B …

http://www.aoa.gov/AOARoot/AoA_Programs/HPW/Diabetes/docs/Instructions%20for%20Obtaining%20a%20Medicare%20Provider%20Number.pdfMedicare Provider Enrollment Process Introduction
Jan 31, 2013 … The applicant should also pay attention to the following key provisions, by form number: CMS Form 855B. SECTION 1: BASIC INFORMATION.

https://pecos.cms.hhs.gov/pecos/help-docs/Paygov%20FAQs.pdfPay.gov FAQs – Pecos
Medicare enrollment application using the CMS-855A, CMS-855B (except … Once you are on Pay.gov, type „CMS‟ in the search box under “Find Public Forms”.

http://www.wsma.org/Media/PRC-pdfs-Coding/CMS_MedicareClaimSubmissionGuidelines.pdfMedicare Claim Submission Guidelines – Washington State Medical …
Form CMS-855B/Medicare Enrollment. Application for Clinics/Group Practices and Certain Other Suppliers: Application used by group practices and other.

http://www.jointcommission.org/assets/1/18/asc_med_deemed_status_flyer_2010.pdf5 Steps to Achieving Medicare Deemed Status … – Joint Commission
It is crucial that the 855B Form – an official CMS document – is completed, submitted and accepted by your State authority prior to scheduling a deemed status …

http://www.asipp.org/documents/CMS855I.PDFMEDICARE ENROLLMENT APPLICATION – American Society Of …
be submitted as an IDTF and you must complete and submit the CMS-855B. The Medicare … The information you provide on this form will not be shared.

http://development.aao.org/aaoesite/coding/upload/R286PI.pdfMedicare Program Integrity Manual – American Academy of …
The Medicare administrative contractor is hereby advised that this constitutes …… For CMS-855A and CMS-855B applications, if the form is signed but it appears …